Cash, beer, doughnuts: Can incentives work to get people vaccinated?

Beer, doughnuts, coupons, even golden pins.

These are just some of the things that places are offering to encourage people to get vaccinated against COVID-19.

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It’s hard to believe, but in a matter of weeks, some parts of the globe have gone from trying to get enough vaccines, to now having them, and trying to convince people to take them.  

Serbia now has a surplus of vaccines and plenty of options, too. In response, last week, President Aleksandar Vučić made a bold offer: cash for shots.  As in, get vaccinated this month, and receive about $30.

Around the same time, inside a shopping center in Belgrade, a line of people stretched around stores and up an escalator to a new, walk-in vaccine clinic. The first 100 to show up got a gift card.

In Romania, Bran Castle had another offer. Visit the legendary home of Dracula this month, and get stabbed while you’re there.

In the arm, that is.

Alex Priscu, the castle’s marketing manager, said they set up the vaccine drive for the first time last weekend, expecting about 200 people to show up.

“We have managed to go further than the limit because we’ve closed the weekend with 400 vaccines,” he said, which even included some staff who were drawn to the convenience. “But our goal is to just raise awareness.”

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The jab, plus a ticket, also gets a person free access to the castle’s torture chambers.

But can a little incentive really make a difference on this massive public health challenge?

“I think incentives within reason are a good approach. I think they can make good sense.”

“I think incentives within reason are a good approach. I think they can make good sense,” said Jeffrey Lazarus, a professor at the Barcelona Institute for Global Health.

Given that as many people as possible need to be vaccinated to prevent outbreaks of the coronavirus and achieve herd immunity, he said, why not see if a shot of beer for a COVID-19 shot might help?

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Incentives for vaccines also aren’t new. Places like Brazil have successfully used cash transfers for childhood vaccinations. New survey results in the US suggests that paying people $100 for getting vaccinated could be effective for some groups.

It’s not just tangible gifts that can be powerful.

In Israel, “green [vaccine] passes” grant access to gyms, concerts and restaurants, and allow for travel. Lazarus, for example, is traveling in Denmark right now. When he has the chance to get vaccinated, he says he will jump on it. It will make it even easier to get into places. Right now, he can’t enter a yoga studio or a bar without proof of a recent negative COVID-19 test, which means having to constantly be tested.

Yet, these kinds of incentives won’t move everyone. Lazarus’ own research across more than a dozen countries has found that those with very low confidence in the vaccines probably won’t be won over this way.

“In the end, if there’s not trust in the vaccines, the science behind the vaccines and health authorities administering the vaccines, I don’t think a doughnut or a drink is going to be the incentive that gets people to go get vaccinated.” 

“In the end, if there’s not trust in the vaccines, the science behind the vaccines and health authorities administering the vaccines, I don’t think a doughnut or a drink is going to be the incentive that gets people to go get vaccinated,” Lazarus said.

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What’s needed is better education on how the vaccines are developed and on their safety.

This is partly why Zoran Radovanovic, a retired epidemiologist at the University of Belgrade, was disappointed with that $30 incentive in Serbia. He worries that for some, cash might spark more suspicion in a government that many already distrust. Like, what’s the catch?

“If the government insists on such a measure, then it might be good for them, but not necessarily for me,” he said.

For Radovanovic, who is 81 years old, the memory of the campaign to eradicate smallpox in Serbia 50 years ago is still fresh. Back then, he says everyone wanted to get vaccinated. People crowded health centers because they knew these shots would save them and their children. They understood vaccination was a public good.

Now, Radovanovic hopes that with these new vaccines for COVID-19, as the holdouts see more people they know getting the shot and observe that they are doing fine, that will make the real difference.

“It takes time for people to be sure that it is for their own good,” he said.